The surgical treatment of fissure is known as Lateral Internal Sphincterotomy (LIS). This procedure involves stretching or cutting the muscles that surround the anus. This procedure is usually quite painful and is feared by patients. However, when performed with the use of a laser, the procedure is completely painless & bloodless.
Laser treatment for fissure takes roughly about 30 minutes. The fissure surgery by laser is done as a daycare procedure and the patient gets discharged within 24 to 48 hours. Laser treatment for fissure is a minimally invasive technique and the patient hardly experiences any pain. It is the permanent solution for fissure, but the patient is required to follow all given instructions so that all the complications are kept at bay. A fissure surgery by laser provides instantaneous relief. Laser treatment for fissure is completely safe, with no damages to either the skin or any of the organs of the patient.
Procedure for laser treatment for fissure.
The procedure for the laser treatment for fissure is of two types
The CO2 Laser technique
This technique involves the use of co2 laser
The laser treatment for fissure begins with the application of local anaesthesia.
The infrared radiation from the laser is then used to increase the blood flow to the area of the fissure. This results in the proper healing of the fissure.
The use of a CO2 laser is because it offers a fixed area of concentration and greater control of the surgery. Also, with the use of a CO2 laser, there’s a lesser chance of recurrence of the fissure compared to traditional surgeries.
There second technique for laser treatment for fissure is known as sphincterotomy. This is carried on the internal anal sphincter muscle, which is a part of the circular internal muscles that control the passage of faeces. The internal anal sphincter is one of the two muscles that make up the anal sphincter.
In this surgery, the sphincter is either partially divided with the help of a scalpel to reduce spasm and the resting pressure, without upsetting the use of the sphincter. This improves blood supply to the fissure area and helps it heal faster.
This technique is usually recommended for its simplicity and the fact that it causes a smaller wound. It’s highly effective with a success rate of around 95%.
However, if carried out by an inexperienced surgeon it can cause loss of control of sphincter tone.
Benefits of laser treatment for fissure
- It involves very low pain.
- Quick recovery time.
- An easy procedure.
- Faecal incontinence or faecal leakage is dodged.
- Little to no bleeding.
- Post-surgery care and pain are too less.
- Return to normal activity is usually within 24 hours.
- No cuts or open wounds.
What is a fissure?
A fissure, also known as an anal fissure, is a slight cut or tear in the lining of the anus. This tear may lead to painful bowel movement along with bleeding, itching and often a foul-smelling discharge.
What are the causes and risk factors of fissure?
When the anal canal gets overstretched beyond its limit, it tears and leads to a fissure. The overstretching of the anal canal may be due to
- Passing large or hard formed stools
- Muscle spasms
- Sexually transmitted infections, such as HIV and syphilis.
- Constipation and strain during bowel movements.
- Anal sex
- Childbirth: Women are at an increased risk of anal fissures after childbirth
- Certain health conditions such as Crohn’s disease, inflammatory bowel disease, anal cancer and tuberculosis.
- Chronic and prolonged diarrhoea.
What are the symptoms of a fissure?
- Feeling a full bowel even after passing of stools several times.
- Pain during bowel movements, which may be severe, and possibly lasting for several hours later.
- Bright red blood on stools or toiletries used in cleaning up.
- A tear in the anus.
- A small lump on the skin around the fissure.
- Burning or itching sensation with pain.
- Discomfort during urinating.
- Frequent urination or inability to urinate.
- Foul-smelling discharge.
How is a fissure diagnosed?
A physical examination of the anal area is more than enough to diagnose a fissure.
However, further analysis such as anoscopy, a flexible sigmoidoscopy, or a colonoscopy, depending upon the patient, might be performed to find out the degree of the tear.